Assessing aptitude

As readers of this blog will know, I am no fan of the so-called ‘points system’ in Ireland, under which applicants for university programmes are admitted in accordance with the points score they achieved on foot of their final school examination results (the Leaving Certificate). The result of this system is that the points needed to enter a certain course are determined by supply and demand rather than the demands of the course. For example, one of the most popular degree programmes has been law, and so it has attracted very high points requirements; whereas science subjects have been less popular, and students have been able to get admitted on much lower points – yet few would argue that science students need to be less gifted intellectually than law students. I have written on this topic in the past. My view has been that almost anything would be better than the points system, as it is pushing young people into careers for which they may not be best suited and which they are choosing solely because of the points attached to the relevant degree programmes.

When therefore those universities with medical schools, under some external pressure, agreed last year to alter their selection processes for medicine by introducing an aptitude test, I was certainly willing to consider this as a potentially useful initiative. What these institutions did was to use the Health Professions Admission Test (HPAT), which has been developed by an Australian company. This consists of a multiple choice paper, which the student must pass and the results of which are then included in the computation of the points score (together with the Leaving Certificate results).

As the first group of would-be medical students has just undertaken this exercise, a debate has come alive as to whether it is a sensible mechanism, and indeed whether it might be applied to other programmes as well. In an article in yesterday’s Irish Independent newspaper it is suggested that the Department of Education and Science might like to see this kind of testing considered more generally, while in the same paper the leading oncologist (and DCU adjunct professor) John Crown expresses serious reservations about the capacity of this kind of test to measure aptitude (or perhaps anything very much), and argues that a it may end up ‘favouring the clever work-shirker over the diligent student’. And still in the Irish Independent, the chief executive of the Higher Education Authority, Tom Boland, takes a very different view and argues as follows:

‘The approach taken by the HPAT, combined with the Leaving Cert, provides an additional means of predicting the aptitude of a student for a particular programme. It operates in a number of other countries as part of the selection process for higher education. Unlike an interview process, it is transparently objective…

Far from decrying the HPAT we should seek ways in which this approach can be used more widely in our education system in tandem with older tried and trusted models of assessment.’

I’m not altogether sure where I stand on this, in large part because I have not seen what the HPAT looks like (though I have just ordered a sample paper). On the one hand, I am very strongly in favour of finding something better than the points system, which has over recent years become more and more damaging to Irish society. On the other hand, an aptitude test consisting of a multiple choice paper, which can be (and will be) the subject of grind school preparation, probably isn’t the answer either. John Crown’s view that only the very best should study medicine (and the nature of that profession may mean he is right) can be met by attaching a very high minimum points requirement to that programme. But we need to move away quickly from the current idea that in order to study biotechnology you only need to be about half as intelligent as you have to be to study law.

I am still inclined to think that once you have set genuine performance thresholds actual selections could be made by lottery, as has been done in the Netherlands. It would be better than what we have now, and would avoid adding one more controversial and maybe dubious testing element.

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11 Comments on “Assessing aptitude”

  1. Aoife Citizen Says:

    I did the leaving cert before the grades were subdivided, this meant that many courses a substantial number of people had the marginal number of points and a fraction of them were selected randomly. This didn’t effect me, but I do remember that people who lost out in a random selection found it acutely galling and dispiriting.

    I know; objecting to the solution doesn’t solve the problem and I don’t have a solution, all I can say is, that having been an interviewer for collegiate admissions in Cambridge, interviewing doesn’t either.

    Perhaps the real solution for many of the professions is to address the underlying problem, rather than the symptom: their anomalous popularity, often sustained by the self-serving behaviour of the corresponding professional bodies.

  2. Vincent Says:

    How about halting the State sponsored fiction, and open up the medical schools. We have been casting around for high level jobs for people when in this example the reason for the narrowness is an agreement between the State and a Trade body. Also it is time to stop the fiction of calling the Medics professionals when they are a trade body like any other. Would we allow the plumbers or electricians to restrict numbers.
    And you are correct, a Lotto is the way to go, anyone getting over 450 points, into a drum. While as to Crown he is also correct, the damage this silly test will do will be enormous for those who fail it. And it will be seen as a fail, where they will be sneered at by their peers. This is just a nasty little sting added to a nasty little system.
    For all entry, a minimum requirement, after that the Lottery to determine exactly who.

  3. Niamh Says:

    The points system is beyond ridiculous at this point. Science courses are much more difficult than the points required to enter the program. It’s no wonder we have such high drop out rates.

    Medicine has to take into account the personality of a person. There’s no point putting someone into a program if they are incapable of proper social interaction. An aptitude test isn’t going to solve this.

  4. Mark Dowling Says:

    When are we going to confront the obvious – 17/18 is not yet the time to determine whether someone is suitable for medicine etc. Let’s get a “Health Sciences” B.Sc. going which positions students to stream into vet/med/psych/pharm etc. but which, should a student be unsuitable/unwilling to go through into postgraduate medical studies (such as UL’s new grad med school) be suitable for other employment streams. Indenturing students for a decade of medical qualification starting from 17 is a bit too 20th century for my taste.

    • Aoife Citizen Says:

      Mark; I don’t think we need to restrict postgraduate medical students to undergraduates with a health science degree. In the US medical schools take people with all sorts of primary degrees, many with a relevant degree, but some without, and it works quite well.

  5. Quovadis Says:

    Vincent makes a good point about unnecessary restriction of student numbers which means we have to recruit badly needed doctors from the majority world which has a huge shortage. Creating more training positions would reduce the points which are simply a result of supply and demand but then medicine would not have the same social status!

    It’s interesting that the gender balance is being tackled first in medicine rather than any of the other professions such as teaching, nursing etc which have lost significant social status and have a majority of women.(unlike medicine) There are no published plans to tackle these areas. Coupled with the fairly poor administration of the HPAT test this leads to me believe that the old boy network described by the Irish Doctor X in his book “the bitter pill” is the key driver behind this test rather than a genuine effort to improve candidate suitability. (The bitter pill should be required reading for all aspiring medical students, and brings understanding as to why so many women are dropping out and no I do not have any connection to the author!)

    I may be biased as I use psychometric tests in career coaching, but they do provide additional valuable insights when used properly and excellent client feedback indicates they find them useful too.

    Prior test practise of sample questions can improve results slightly but the research indicates results tend to reflect candidates actual abilities IF correctly developed and administered. So grinds are not that helpful at all.

    Unlike the Leaving certificate, the HPAT does assess understanding of people, which would generally be considered to be a desirable quality in doctors, but for unknown reasons the HPAT people have decided not to release these results, even though the CAO system can hold this information.

    Very strange.

  6. Sam Says:

    Lottery system will make a mockery of the whole thing: why bother working hard?

    Forcing people to do additional science(often irrelevant) degree will only delay the problem and make students get frustrated and result in problems such as plagiarism at University. There are many students who know what they want to do by 17. Remember, kids are maturing earlier these days.

    I think HPAT is a great idea. I did a so called grind course (MedEntry) and felt that I learnt the underlying skills that HPAT tests, which I will take with me for life. I felt I learnt more from that course than from two years of school. What is wrong with that?

  7. Ciaran Says:

    IMHO the majority of candidates that exceed around the 500 mark and really really want to do medicine are probably well able to do it.

    The systems reaction to large numbers not getting medicine has been to try and better tailor the rationing process by introducing the HPAT.

    If an area demands high points it is a direct result of popularity… so the very obvious solution would be rather than to continue to ration places, we should instead simply create more! Why do we turn down the opportunity to produce large numbers of enthusiastic hard working doctors? Imagine if we doubled the number of places or tripled them – we’d have a moderation in medical costs [wages go down], we’d have more GP competition, we’d have a basis for developing a medical tourism sector and we’d stop this stupid system of people with loads of points, repeating a year of their life to gain maybe an extra 5 more!!! Can anyone think of a bigger waste of resources than funding a persons repeats for the sake of 5 points??

    I think the points system needs the following reforms [IMHO]…

    > Minimum points requirements for ‘difficult’ courses [hard to define… like say minimum 400 for Computer Applications]. Low points in engineering has had the negative effect of making top candidates feel like they are wasting their points on low points courses.
    > An automatic stableiser – if points go above 500 for any course; it should result in a requirment for places to be gradually increased [say by 5-10% pa until points stop rising].
    > The devision of Honors Maths into two subjects [Paper 1 & Paper 2] worth 75 points each for a total of 150 points when being counted for maths dependant courses.

    Thats my two pence! I simply believe that if the points system is based on supply and demand, it should obviously have a reactive component to increase supply once demand hits a high mark.

  8. john crown Says:

    Thye medical profession is not the body which restricts numbers-it is the government. The proper way to select medical students is at graduate level, when they are more mature and less likely to choose medicine because it is seen the first place prize for the good leaving cert.

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